Abstract
Kidney transplantation has emerged as a major advance of modern medicine, providing high-quality life years to patients with end-stage renal disease (ESRD). Post-transplant monitoring of the transplanted kidney is based on physical examination, urine volume, the assessment of albuminuria or proteinuria, serum creatinine, and glomerular filtration rate (GFR) estimation based on serum creatinine. Of these multiple investigations, serum creatinine and urine analysis is one of the most widely used and accepted tool to assess graft dysfunction as well as plan management. Various immunological (rejections-antibody, cellular) and non-immunological (polyoma virus nephropathy, mycosis, recurrent/de novo diseases) may affect the graft function. Changes in various parameters like urine osmolality, proteinuria, hematuria and presence of casts, crystals and other cellular constituents aids in diagnosis diseases of the allograft. This chapter thus highlights the importance of most frequent parameters that help in assessing the graft function. In addition to these parameters, a brief introduction of biomarkers is also included. Many studies have shown that these biomarkers have a promising role in diagnosis of allograft disease and thus avoiding interventional procedures like renal biopsy. Easy availability as well as low-cost of the urine examination makes it a promising tool for overall assessment of the graft dysfunction.